Provider Demographics
NPI:1508468224
Name:SMITH, LORI LYNN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:LYNN
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1462 COUNTY ROAD 302
Mailing Address - Street 2:
Mailing Address - City:FLORESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78114-3604
Mailing Address - Country:US
Mailing Address - Phone:210-289-7569
Mailing Address - Fax:
Practice Address - Street 1:200 BUSINESS PARK BLVD
Practice Address - Street 2:
Practice Address - City:KENEDY
Practice Address - State:TX
Practice Address - Zip Code:78119-2026
Practice Address - Country:US
Practice Address - Phone:830-583-9832
Practice Address - Fax:830-583-9763
Is Sole Proprietor?:No
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41615183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist